Individual provider Active NPI

Joanne Duffy, PH.D

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1124172226
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2700 Issued in MD
Practice address
2411 W Belvedere Ave Ste 504
Baltimore, MD 21215-5232
Phone
(410) 601-0070
Fax
(410) 601-0290
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2700 MD Primary

Addresses

Primary practice location

2411 W Belvedere Ave Ste 504
Baltimore, MD 21215-5232

Mailing address

2411 W Belvedere Ave Ste 504
Baltimore, MD 21215-5232
Phone (410) 601-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000921 MD Practitioner - Clinical Psychologist 7911959085 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2411 W Belvedere Ave
Suite 509
Baltimore, MD 21215-5232
Phone (410) 718-1734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2700MDMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1124172226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 W BELVEDERE AVE STE 504",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155232",
            "telephone_number": "410-601-0070",
            "fax_number": "410-601-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 W BELVEDERE AVE STE 504",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155232",
            "telephone_number": "410-601-0070",
            "fax_number": "410-601-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "2700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.